Traditionally, addiction would refer to a person's physical and psychological dependence on a mind altering substance, such as alcohol, tobacco, or drugs. More recently, mental health care providers have expanded the definition to include any substance or behavior which a person engages in repeatedly, despite negative consequences to their health, social life, or personal relationships.
The American Society of Addiction Medicine expands the definition further, stating that addiction is a “primary, chronic disease of brain reward, motivation, memory and related circuitry […] characterized by inability to consistently abstain, impairment in behavioral control, craving, diminished recognition of significant problems with one’s behaviors and interpersonal relationships, and a dysfunctional emotional response. Like other chronic diseases, addiction often involves cycles of relapse and remission. Without treatment or engagement in recovery activities, addiction is progressive and can result in disability or premature death.”
In recent years, the expanded definition of addiction allows people to be considered addicted to several behaviors besides drug and alcohol use, such as gambling, food, sex, pornography, exercise, and the internet, among others. While these behavioral addictions may not as strongly alter the chemical reward centers in the brain to the same extent as drugs or alcohol do, research suggests that similar processes are occurring. Research strongly suggests that there is a genetic component to addictions, as well as an environmental component (access to addictive materials).
Some people who have an addiction may be able to stop on their own, but most will need help. Although treatment may be different for different behaviors, it usually will involve some form or combination of counseling, behavioral therapies, self-help groups or medical treatment.
Symptoms of addiction, both chemical and behavioral, may be subtle or very apparent. In the case of substance use, patients my experience physical withdrawal symptoms, and using the substance alleviates the withdrawal. In all addictions, patients may engage in the substance/behavior for longer periods of time or in greater quantities, and may want to or try to quit but are unable to do so. They may spend extensive amounts of time trying to find or using the substance or engaging in the behavior. Ultimately, they will continue to use the substance or engage in the behavior despite problems brought on by it (ex. lung disease from smoking, or high debt from gambling).
Listed below are symptoms of various types of addictions:
Tobacco abuse harms every organ in the body. It has been conclusively linked to leukemia, cataracts, and pneumonia, and accounts for about one-third of all cancer deaths. The overall rates of death from cancer are twice as high among people who smoke as those who don’t, with people who smoke heavily having rates that are four times greater than those of people who don’t smoke.
People who smoke also lose some of their sense of smell and taste, don’t have the same stamina for exercise and sports they once did, and may smell of smoke. After smoking for a long time, people find that their skin ages faster and their teeth discolor or turn brown.
When nicotine addicts stop smoking they may suffer from restlessness, hunger, depression, headaches, and other uncomfortable feelings. These are called "withdrawal symptoms" because they happen when nicotine is withdrawn from the body.
Sexual behavior that mirrors patterns of other addictive behaviors has similar symptoms to all addictions, such as: recurrent failure to resist the impulse to engage in sexual behaviors, despite wanting to or being unable to stop -inordinate amounts of time and effort spent in obtaining sex or engaging in sexual behaviors -engaging in sexual behavior instead of fulfilling work, family or social obligations, as well as continuing these behaviors as these areas suffer. -increasing tolerance to the behavior requiring increases in the intensity, frequency and risk of the behavior.
When one becomes preoccupied by sexual thoughts and/or engages in risky sexual behaviors which lead to conflict in relationships or avoidance of relationships (and other negative consequences), we could say that an individual has a sexual addiction. This is because it meets the general criteria for "addiction." Another term used to describe sexual addiction is Compulsive Sexual Behavior.
The following are symptoms of drug addiction:
- You’ve built up a drug tolerance. You need to use more of the drug to experience the same effects you used to attain with smaller amounts.
- You take drugs to avoid or relieve withdrawal symptoms. If you go too long without drugs, you experience symptoms such as nausea, restlessness, insomnia, depression, sweating, shaking, and anxiety.
- You’ve lost control over your drug use. You often do drugs or use more than you planned, even though you told yourself you wouldn’t. You may want to stop using, but you feel powerless.
- Your life revolves around drug use. You spend a lot of time using and thinking about drugs, figuring out how to get them, and recovering from the drug’s effects.
- You’ve abandoned activities you used to enjoy, such as hobbies, sports, and socializing, because of your drug use.
- You continue to use drugs, despite knowing it’s hurting you. It’s causing major problems in your life—blackouts, infections, mood swings, depression, paranoia—but you use anyway.
Symptoms of food addiction can include the obsession and preoccupation with food and eating, an inability to control oneself around food, binging and eating despite negative consequences, eating when not hungry, rapid eating, feeling shame and embarrassment that results in solitary eating, and decreased pleasure from eating. Often food addicts have a preoccupation with their weight and have a history of dieting unsuccessfully.
The most common food addiction symptoms include consuming large amounts for a long period, repeated attempts to cut down, and continued use despite adverse consequences. Tolerance and time effort are further, but less frequent symptoms. Withdrawal symptoms and reduction of social, occupational, or recreational activities are rarely reported.
People who have alcoholism or alcohol abuse often:
- continue to drink, even when health, work, or family are being harmed
- drink alone
- become violent when drinking
- become hostile when asked about drinking
- are not able to control drinking -- being unable to stop or reduce alcohol intake
- make excuses to drink
- miss work or school, or have a decrease in performance because of drinking
- Ssop taking part in activities because of alcohol
- need to use alcohol on most days to get through the day
- neglect to eat or eat poorly
- do not care about or ignore how they dress or whether they are clean
- try to hide alcohol use
- shake in the morning or after periods when they have not had a drink
Symptoms of alcohol dependence include:
- memory lapses after heavy drinking
- needing more and more alcohol to feel "drunk"
- alcohol withdrawal symptoms when you haven't had a drink for a while
- alcohol-related illnesses such as alcoholic liver disease
Addiction is a broad term for various types of addictions. Listed below is information on different types of addiction.
Nicotine dependence is an addiction to tobacco products caused by the drug nicotine. Nicotine dependence — also referred to as tobacco dependence — means you can't stop using the substance, even though it's causing you harm. While it's the nicotine in tobacco that causes nicotine dependence, the toxic effects come mainly from other substances in tobacco. Smokers have much higher rates of heart disease, stroke and cancer than do nonsmokers.
Nicotine produces physical and mood-altering effects in your brain that are temporarily pleasing. These effects make you want to use tobacco and lead to dependence. At the same time, stopping tobacco use causes withdrawal symptoms, including irritability and anxiety.
It is important to keep in mind that not all interest in sex is an addiction. Because sexual addiction is much more common among men, it is not uncommon for sex therapists to encounter couples in which the female is concerned that her male partner is addicted to sex. This may be particularly relevant when considering pornography. Many men (and women) enjoy viewing pornography. Certainly, viewing pornography by itself does not constitute a sexual addiction.
However, if it is excessive, causes problems in the relationship, and produces negative consequences, then discussing the possibility of an addiction becomes necessary.
Here are some common examples of behaviors that may indicate an addiction:
- Being unable or unwilling to have sex with your partner except while viewing pornography,
- Spending large quantities of money on sex (i.e., pornography, prostitutes, and phone sex),
- Not going to work because the majority of the day was spent engaging in sex, or viewing sexual material.
Similar to other addictions, the addict may minimize or ignore the harm they are causing to themselves or others. Therefore, treatment is often delayed until some crisis occurs.
Drug abusers often try to conceal their symptoms and downplay their problem. If you’re worried that a friend or family member might be abusing drugs, look for the following warning signs:
- Bloodshot eyes, pupils larger or smaller than usual.
- Changes in appetite or sleep patterns. Sudden weight loss or weight gain.
- Deterioration of physical appearance, personal grooming habits.
- Unusual smells on breath, body, or clothing.
- Tremors, slurred speech, or impaired coordination.
Behavioral signs of drug abuse
- Drop in attendance and performance at work or school.
- Unexplained need for money or financial problems. May borrow or steal to get it.
- Engaging in secretive or suspicious behaviors.
- Sudden change in friends, favorite hangouts, and hobbies.
- Frequently getting into trouble (fights, accidents, illegal activities).
Psychological warning signs of drug abuse
- Unexplained change in personality or attitude.
- Sudden mood swings, irritability, or angry outbursts.
- Periods of unusual hyperactivity, agitation, or giddiness.
- Lack of motivation; appears lethargic or “spaced out.”
- Appears fearful, anxious, or paranoid, with no reason.
Many of the clinical criteria for addiction/dependence focus on the consequences of continued use or on failure to discontinue use. If there are no negative consequences of eating food and there are no failed attempts to discontinue eating large amounts or certain types of food, there is no diagnosis of addiction. On this basis, most healthy, normal-weight people would not be diagnosed as food addicts and food would not be considered an addictive substance, because, for the most part, it produces positive rather than negative consequences.
Food addiction diagnoses are positively associated with BMI and, therefore, increased in obese individuals and even more in obese patients with binge eatng disorder (BED). Moreover, this relationship between body mass and food addiction may be non-linear. Interestingly, participants who received a food addiction diagnosis did not differ in body mass from non-food addicted participants. This result could also be confirmed in a sample of obese individuals seeking bariatric surgery where food addicted participants (40%) did not differ in BMI from non-food addicted participants.
The health care provider will perform a physical exam and ask questions about your medical and family history, including use of alcohol.
The following questions are used by the National Institute on Alcohol Abuse and Alcoholism to screen for alcohol abuse or dependence:
- Do you ever drive when you have been drinking?
- Do you have to drink more than before to get drunk or feel the desired effect?
- Have you felt that you should cut down on your drinking?
- Have you ever had any blackouts after drinking?
- Have you ever missed work or lost a job because of drinking?
- Is someone in your family worried about your drinking?
Tests that may be done include:
- Blood alcohol level (this can tell whether someone has recently been drinking alcohol, but it does not necessarily confirm alcoholism)
- Complete blood count (CBC)
- Liver function tests
- Magnesium blood test
Can addiction be treated successfully?
Yes. Addiction is a treatable disease. Discoveries in the science of addiction have led to advances in drug abuse treatment that help people stop abusing drugs and resume their productive lives.
Can addiction be cured?
Addiction need not be a life sentence. Like other chronic diseases, addiction can be managed successfully. Treatment enables people to counteract addiction's powerful disruptive effects on brain and behavior and regain control of their lives.
What are the principles of effective addiction treatment?
Research shows that combining treatment medications, where available, with behavioral therapy is the best way to ensure success for most patients. Treatment approaches must be tailored to address each patient's drug abuse patterns and drug-related medical, psychiatric, and social problems.
Causes of addiction can vary based on the type of addiction. Listed below are the causes of various types of addiction.
People experiment with drugs for many different reasons. Many first try drugs out of curiosity, to have a good time, because friends are doing it, or in an effort to improve athletic performance or ease another problem, such as stress, anxiety, or depression. Use doesn’t automatically lead to abuse, and there is no specific level at which drug use moves from casual to problematic. It varies by individual. Drug abuse and addiction is less about the amount of substance consumed or the frequency, and more to do with the consequences of drug use. No matter how often or how little you’re consuming, if your drug use is causing problems in your life—at work, school, home, or in your relationships—you likely have a drug abuse or addiction problem.
Why do some drug users become addicted, while others don’t?
As with many other conditions and diseases, vulnerability to addiction differs from person to person. Your genes, mental health, family and social environment all play a role in addiction. Risk factors that increase your vulnerability include:
- Family history of addiction
- Abuse, neglect, or other traumatic experiences in childhood
- Mental disorders such as depression and anxiety
- Early use of drugs
- Method of administration—smoking or injecting a drug may increase its addictive potential
In humans, increasing evidence suggests that individuals with binge eating-related disorders, i.e., bulimia nervosa (BN), binge eating disorder (BED), and obesity, experience behavioral symptoms and neurochemical changes that are highly comparable to other addictive behaviors. In recent years, neuroendocrine pathways have been identified that are involved in both drug- and food-seeking behaviors. Specifically, appetite-regulating peptides like ghrelin, neuropeptide Y, orexin, or leptin have also been associated with craving for alcohol or tobacco.
It is sometimes asserted that obesity rates have increased because there is too much palatable food available. However, although palatability does increase intake in the short term, it is not clear that palatable food leads to overeating over the long term. Many parallels have been drawn between substance dependence and excessive consumption of such hyperpalatable foods. Animal models show that rats develop behavioral symptoms, but also show neurochemical changes, that are comparable to drug use when they have intermittent access to sugar and chow or receive a cafeteria-like diet.
Cigarettes and other forms of tobacco—including cigars, pipe tobacco, snuff, and chewing tobacco—contain the addictive drug nicotine. Nicotine is readily absorbed into the bloodstream when a tobacco product is chewed, inhaled, or smoked.
Upon entering the bloodstream, nicotine immediately stimulates the adrenal glands to release the hormone epinephrine (adrenaline). Epinephrine stimulates the central nervous system and increases blood pressure, respiration, and heart rate. Glucose is released into the blood while nicotine suppresses insulin output from the pancreas, which means that smokers have chronically elevated blood sugar levels.
Like cocaine, heroin, and marijuana, nicotine increases levels of the neurotransmitter dopamine, which affects the brain pathways that control reward and pleasure. For many tobacco users, long-term brain changes induced by continued nicotine exposure result in addiction—a condition of compulsive drug seeking and use, even in the face of negative consequences. Studies suggest that additional compounds in tobacco smoke, such as acetaldehyde, may enhance nicotine’s effects on the brain. A number of studies indicate that adolescents are especially vulnerable to these effects and may be more likely than adults to develop an addiction to tobacco
There is no single cause of sexual addiction. Multiple research studies indicate that up to 60% to 80% of people with sexual addiction were victims of child abuse. There is also frequent comorbidity with depression, anxiety and obsessive-compulsive disorders. Many researchers believe that sexual addiction follows the same neural pathways as drug and alcohol abuse.
Compulsive Sexual Behavior typically begins in late adolescence or early adulthood and impacts men more so than women. There may actually be brain impairments in individuals who have a sexual addiction which makes it so that they cannot judge the danger and negative impact of their sexual behavior. Alternatively, individuals with sexual addiction may have such impaired impulse control they immediately gratify sexual cravings without regard to the consequences. Regardless of the reasons, sexual addicts may seek out stimulation by viewing pornography, engaging in cybersex, or having sex with others, often paid, sex-trade workers. This puts them at risk for a number of life-threatening illnesses (e.g., AIDS), legal problems, (e.g., purchasing child pornography), and financial ruin.
There is no known cause of alcohol abuse or alcoholism. Research suggests that certain genes may increase the risk of alcoholism, but which genes and how they work are not known. How much you drink can influence your chances of becoming dependent.
Those at risk for developing alcoholism include:
- Men who have 15 or more drinks a week
- Women who have 12 or more drinks a week
- Anyone who has five or more drinks per occasion at least once a week
- One drink is defined as a 12-ounce bottle of beer, a 5-ounce glass of wine, or a 1 1/2-ounce shot of liquor.
- You have an increased risk for alcohol abuse and dependence if you have a parent with alcoholism.
You may also be more likely to abuse alcohol or become dependent if you:
- Are a young adult under peer pressure
- Have depression, bipolar disorder, anxiety disorders, or schizophrenia
- Have easy access to alcohol
- Have low self-esteem
- Have problems with relationships
- Live a stressful lifestyle
- Live in a culture alcohol use is more common and accepted
Alcohol abuse is rising. Around 1 out of 6 people in the United States have a drinking problem.
Getting Help with addiction is crucial to overcoming controlling nature of addictions. There are many support services, groups, and organizations that offer help with ending addiction. Information on specific addiction support services is listed below.
- Visit a Narcotics Anonymous meeting in your area.
- Recognizing that you have a problem is the first step on the road to recovery, one that takes tremendous courage and strength.
- Facing your addiction without minimizing the problem or making excuses can feel frightening and overwhelming, but recovery is within reach.
- If you’re ready to make a change and willing to seek help, you can overcome your addiction and build a satisfying, drug-free life for yourself.
Support is essential to addiction recovery
Don’t try to go it alone; it’s all too easy to get discouraged and rationalize “just one more” hit or pill. Whether you choose to go to rehab, rely on self-help programs, get therapy, or take a self-directed treatment approach, support is essential. Recovering from drug addiction is much easier when you have people you can lean on for encouragement, comfort, and guidance.
There are a couple of options available to quit overeating. A therapist can help the person stop turning to food to zone out or for comfort and therapy is typically the best bet for those seeking compulsive eating help. The addiction may be a symptom of an underlying condition, such as abuse, which needs to be addressed to help the client learn to have a more healthy relationship with food and discover how to stop compulsive overeating.
A support group, such as Overeaters Anonymous or Food Addicts in Recovery Anonymous, can also be part of the treatment process. As most food addicts tend to suffer from low self-esteem and/or depression, a group like Emotions Anonymous might also be able to help. Sharing experiences and getting support from people who understand the addiction can be an effective part of treatment.
If someone you know is smoking or using tobacco in another way, encourage him or her to talk to a parent, school guidance counselor, or other trusted adult. A national toll-free number, 1-800-QUIT-NOW (1-800-784-8669), can help people get the information they need to quit smoking. Callers to the number are routed to their state’s smoking cessation quitline or, in states that have not established quitlines, to one maintained by the National Cancer Institute. In addition, a Web site—www.smokefree.gov—from the U.S. Department of Health and Human Services offers online advice and downloadable information to make stopping easier.
The bottom line: People who quit smoking can have immediate health benefits. Believe it or not, within 24 hours of quitting, a person’s blood pressure decreases and they have less of a chance of having a heart attack. Over the long haul, quitting means less chance of stroke, lung and other cancers, and coronary heart disease, and more chance for a long and healthy life.
Facilities that do not provide sex addiction help directly may refer patients to a sexual addiction treatment center if sexual issues are detected during treatment for chemical dependency for example.
In cases where sexual addiction has led to exceptionally serious problems, such as when an unfaithful person has exposed the partner to HIV infection, or when sexual misconduct has occurred that could result in legal charges, loss of professional license, and financial adversity for the family, sex and love addiction rehab centers like The Sexual Recovery Institute can provide a certified sex addiction therapist who has the training necessary to assist clients in navigating these uniquely difficult situations. Certified Sex Addiction Therapists or CSAT’s have extensive long-term training and supervision in the management of sex addiction cases.
Sex addiction counselors face challenges different from those of other addiction specialists. Unlike the goal in treatment of chemical dependency, which is abstinence from use of all psychoactive substances, the therapeutic goal in sexual addiction is abstinence only from compulsive sexual behavior with a coexisting goal, that of adapting and integrating healthy sexuality.
Do you think someone close to you has an alcohol problem? Do you have a problem with drinking? Either way, there's no need to go it alone. You need support right now and the organizations below can lend a hand. Don't worry; they're there to help you. You won't get in trouble or blamed for anything.
National Association for Children of Alcoholics Help for kids who are hurt by a parent's alcohol use.
- Contact: 1-888-55-4COAS or (1-888-554-2627)
- Support for teens whose lives have been affected by someone drinking.
- Contact: 1-888-4AL-ANON or (1-888-425-2666)
- Help for family and friends of people with drinking problems.
- Contact: 1-888-4AL-ANON or (1-888-425-2666)
- Support for anyone who wants to stop drinking.
- Contact: Find your local organization
- Contact: 1-800-662-HELP
Addiction is common in people with mental health problems
- According to reports published in the Journal of the American Medical Association:
- Roughly 50 percent of individuals with severe mental disorders are affected by substance abuse.
- 37 percent of alcohol abusers and 53 percent of drug abusers also have at least one serious mental illness.
- Of all people diagnosed as mentally ill, 29 percent abuse either alcohol or drugs.
Many drug-addicted individuals also have other mental disorders. Because drug abuse and addiction—both of which are mental disorders—often co-occur with other mental illnesses, patients presenting with one condition should be assessed for the other(s). And when these problems co-occur, treatment should address both (or all), including the use of medications as appropriate.
Living with addiction can be debilitating. Whether you are suffering from addiction yourself or someone you care about is suffering from addiction; Addiction makes everyday tasks very difficult. Information on living with various types of addictions is listed below.
When a loved one has a drug problem
If you suspect that a friend or family member has a drug problem, here are a few things you can do:
- Speak up. Talk to the person about your concerns, and offer your help and support, without being judgmental. The earlier addiction is treated, the better. Don’t wait for your loved one to hit bottom! Be prepared for excuses and denial by listing specific examples of your loved one’s behavior that has you worried.
- Take care of yourself. Don’t get so caught up in someone else’s drug problem that you neglect your own needs. Make sure you have people you can talk to and lean on for support. And stay safe. Don’t put yourself in dangerous situations.
- Avoid self-blame. You can support a person with a substance abuse problem and encourage treatment, but you can’t force an addict to change. You can’t control your loved one’s decisions. Let the person accept responsibility for his or her actions, an essential step along the way to recovery for drug addiction.
Attempt to punish, threaten, bribe, or preach.
Try to be a martyr. Avoid emotional appeals that may only increase feelings of guilt and the compulsion to use drugs.
- Cover up or make excuses for the drug abuser, or shield them from the negative consequences of their behavior.
- Take over their responsibilities, leaving them with no sense of importance or dignity.
- Hide or throw out drugs.
- Argue with the person when they are high.
- Take drugs with the drug abuser.
- Feel guilty or responsible for another's behavior.
Men and Women who are Compulsive Overeaters will sometimes hide behind their physical appearance, using it as a blockade against society (common in survivors of sexual abuse). They feel guilty for not being "good enough," shame for being overweight, and generally have a very low self-esteem... they use food and eating to cope with these feelings, which only leads into the cycle of feeling them ten-fold and trying to find a way to cope again.
Quitting eating is obviously not a possibility for food addicts or anyone for that matter, so they need to learn how to have a better relationship with food. Medications can be prescribed for depression or anxiety, but patient and effective therapy is the key to compulsive over eating recovery.
Smoking doesn’t just affect the person who smokes. People who do not smoke are exposed to “secondhand smoke,” which comes from both the exhaled smoke and from the smoke floating from the end of a cigarette, cigar, or pipe. Inhaling secondhand smoke increases a person’s risk of developing heart disease by 25 to 30 percent and lung cancer by 20 to 30 percent. In fact, secondhand smoke is estimated to contribute to as many as 40,000 deaths related to heart disease and about 3,000 lung cancer deaths per year among people who do not smoke. Secondhand smoke also causes respiratory problems in people who do not smoke, like coughing, phlegm, and reduced lung function.
Children exposed to secondhand smoke are at an increased risk for sudden infant death syndrome, acute respiratory infections, ear problems, and more severe asthma. And, believe it or not, dropped cigarettes are the leading cause of residential fire fatalities, leading to more than 700 such deaths each year.
Each year, almost half a million Americans die from tobacco use. One of every five deaths in the United States is a result of tobacco use, making tobacco more lethal than all other addictive drugs combined.
Clearly, sexual addiction can cause great harm to relationships. Considering that sex is still a taboo, there may be a great deal of shame associated with sexual addictions. Partners of individuals who have a sexual addiction may be very distraught by their partner's dishonesty and secret life. They may feel a sense of betrayal, and fear the legal, economic, and personal repercussions, they endure as a result of their partner's addiction. To complicate matters further, the great deal of taboo associated with sex may not allow for discussion of the matter, and limits the amount of social support the individual receives.
Support groups are available to help people who are dealing with alcoholism.
Alcoholics Anonymous (AA)
- Alcoholics Anonymous (AA) is a self-help group of recovering alcoholics that offers emotional support and specific steps for people recovering from alcohol dependence. The program is commonly called a "12-step" approach. There are local chapters throughout the United States. AA offers help 24 hours a day and teaches that it is possible to participate in social functions without drinking.
- Family members of a person with an alcohol abuse problem often need counseling. Al-Anon is a support group for partners and others who are affected by someone else's alcoholism.
- Alateen provides support for teenage children of people with alcoholism.
Several other support groups are available:
- SMART recovery teaches you have to change your thoughts and behaviors to help people with alcoholism recover.
- LifeRing recovery and SOS are two nonreligious programs that offer support for people with alcohol abuse.
- Women for Sobriety is a self-help group just for women.
- Moderation Management is a program for those who want to reduce how much they drink. It recommends abstinence for people who cannot do this.